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女性抑郁症患者的长期舍曲林治疗与外周生化标志物

Long-term sertraline treatment and peripheral biochemical markers in female depressed patients.

作者信息

Pivac Nela, Mück-Seler Dorotea, Sagud Marina, Jakovljević Miro, Mustapić Maja, Mihaljević-Peles Alma

机构信息

Laboratory for Molecular Neuropharmacology, Division of Molecular Medicine, Ruder Bosković Institute, P.O. Box 180, HR-10002 Zagreb, Croatia.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 2003 Aug;27(5):759-65. doi: 10.1016/S0278-5846(03)00105-2.

Abstract

Serotonergic system is implicated in the pathogenesis of depression. Peripheral biochemical markers, platelet serotonin (5-HT) and platelet monoamine oxidase (MAO) activity were determined spectrofluorimetrically at baseline and after 4 and 24 weeks of sertraline (a selective serotonin reuptake inhibitor (SSRI)) treatment in 15 female nonsuicidal, nonpsychotic patients with major depression and compared with 15 drug-free healthy women. The aim of the study was to determine the effects of 4 and 24 weeks of sertraline treatment on platelet 5-HT concentration and platelet MAO activity in depressed patients subdivided according to the treatment response into remitters, responders and nonresponders after 4 and 24 weeks of sertraline treatment based on the 70%, 50-69% and <49% reductions in baseline Montgomery-Asperg Depression Rating Scale (MADRS) scores, respectively. Platelet 5-HT concentration was significantly lower in all depressed patients at baseline than in healthy subjects. Among patients, platelet 5-HT concentration or platelet MAO activity did not differ before treatment. There was no significant correlation between MADRS scores and peripheral biochemical markers. The limitation of the study was in a small number of patients, but its advantage was in a long-term (24 weeks) follow-up of both patients and healthy controls. Our results show that long-term sertraline treatment induced remission and response in 87% patients, decreased platelet 5-HT concentration after 4 and 24 weeks of treatment and decreased platelet MAO activity after 24 weeks and suggest that pretreatment values of platelet 5-HT and platelet MAO might not predict therapeutic outcome to sertraline treatment in female depressed patients.

摘要

血清素能系统与抑郁症的发病机制有关。对15名无自杀倾向、无精神病的重度抑郁症女性患者,采用荧光分光光度法在基线以及舍曲林(一种选择性5-羟色胺再摄取抑制剂(SSRI))治疗4周和24周后,测定外周生化标志物血小板5-羟色胺(5-HT)和血小板单胺氧化酶(MAO)活性,并与15名未服用药物的健康女性进行比较。本研究的目的是确定舍曲林治疗4周和24周后,根据治疗反应将抑郁症患者分为缓解者、反应者和无反应者,基于蒙哥马利-阿斯伯格抑郁评定量表(MADRS)基线评分分别降低70%、50-69%和<49%,舍曲林治疗对血小板5-HT浓度和血小板MAO活性的影响。所有抑郁症患者基线时的血小板5-HT浓度显著低于健康受试者。患者中,治疗前血小板5-HT浓度或血小板MAO活性无差异。MADRS评分与外周生化标志物之间无显著相关性。本研究的局限性在于患者数量较少,但其优势在于对患者和健康对照进行了长期(24周)随访。我们的结果表明,长期舍曲林治疗使87%的患者缓解或有反应,治疗4周和24周后血小板5-HT浓度降低,治疗24周后血小板MAO活性降低,提示血小板5-HT和血小板MAO的治疗前值可能无法预测女性抑郁症患者对舍曲林治疗的疗效。

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